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African Health Sciences

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Maternal and fetal outcome of gestational diabetes mellitus in Mulago Hospital, Uganda

Emmanuel Odar, Julius Wandabwa, Paul Kiondo

Abstract


Objective: To determine the maternal and foetal outcomes in mothers with gestational diabetes mellitus attending antenatal clinics in Mulago Hospital Kampala Uganda.


Design: This was a cohort study.


Setting: Mulago Hospital antenatal clinics.


Participants: Ninety mothers with gestational ages between 24-32 weeks were recruited from April to September 2001.They were followed up to the time of delivery. The WHO criterion for the diagnosis of gestational diabetes was used. Thirty mothers with a 2 hrs post prandial capillary blood sugar more than 140 mg/dl were the exposed group and 60 mothers with less than 140 mg/ dl were the unexposed group. Blood sugar was measured using a one touch glucometer.


Outcome variables: Socio demographic characteristics, maternal complications, mode of delivery and the foetal outcomes.


Results: The mean age of mothers in both groups was similar: 28.6 years vs 27.5 years. Both groups had similar body mass index more than 26. The mothers with gestational diabetes mellitus (GDM) were four times more likely to have hypertensive disease(p=0.04) and nine times more likely to have vaginal candidiasis(p=0.002). The modes of delivery were similar in both groups but genital injuries were more common among mothers with GDM. The indications of Caesarian section in mothers with GDM were two times more likely to be due to big babies and obstructed labour. The babies for mothers with GDM were more likely to be macrocosmic, still born, and have shoulder dystocia than those of normal mothers.


Conclusion: Gestational diabetes mellitus exists in Uganda and is associated with adverse maternal and foetal outcomes. There is need to routinely screen mothers for gestational diabetes in this environment.

African Health Sciences 2004; 4(1): 9-14



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